"Prohibition of new charges as a result of the creation of Care Trusts

No new charges shall be created for new or existing services as a result of the creation of Care Trusts."

Clause 54

THE EARL HOWE
THE LORD ASTOR OF HEVER

The above-named Lords give notice of their intention to oppose the Question that Clause 54 stand part of the Bill.

Clause 55

THE EARL HOWE
THE LORD ASTOR OF HEVER

The above-named Lords give notice of their intention to oppose the Question that Clause 55 stand part of the Bill.

Before Clause 56

THE LORD CLEMENT-JONES
THE BARONESS BARKER

260

Insert the following new Clause

"Exclusion of charges for personal care

"(1)

Section 22 of the National Assistance Act 1948 (which provides for the assistance of persons in need by local authorities) shall be amended as follows.

(2)

Leave out subsection (2) and insert

"(2)

Subject to the following provisions of this section, the payment which a person is liable to make for any such accommodation shall be in accordance with a standard rate fixed for that accommodation by the authority managing the premises in which it is provided, and that standard rate shall exclude any costs for personal care services as defined in subsection (5) below."

(3)

Section 17 of the Health and Social Services and Social Security Adjudications Act 1983 (which makes provisions relating to the financing of certain social services in England and Wales) shall be amended as follows.

(4)

In subsection (2) after "services" there shall be inserted "excluding any personal care service within the meaning of subsection (3) below".

(5)

In this section `personal care services' means any service or services which a person has been assessed as being in need of under section 47 of the National Health Service and Community Care Act 1990 and which is care provided in respect of the following matters

eating and drinking (but not the obtaining or preparation of food and drink);

(c)

the management of urinary and bowel functions (including the maintenance of continence and the management of incontinence);

(d)

the management of problems associated with immobility;

(e)

the management of prescribed treatment (including the administration) and monitoring of any medication;

(f)

behaviour management and ensuring personal safety (including the reduction of stress or risk for persons with cognitive impairment); or

(g)

associated teaching, enabling and psychological support from a skilled professional, and assistance with cognitive functions to enable a person to undertake personal care tasks himself or with help.""

261

Insert the following new Clause

"Care: duty of Secretary of State

(1)

Where a person has been assessed by a National Health Service body, or any other body or suitably qualified person acting under delegation or under contract to a National Health Service body, or as part of a multi-disciplinary assessment, as reasonably requiring for health care purposes

(a)

nursing care (including any planning, supervision, or delegation of such care) which

(i)

is planned for a person by a registered nurse after assessing that person's need, and

(ii)

is provided, delegated or supervised by a registered nurse,

(b)

the use of any medical, surgical or nursing equipment, or personal aid including that provided by or in a residential or nursing home home, or

(c)

health care wherever provided, including care provided by or in a residential or nursing home.

(2)

Health care includes, the diagnosis, assessment, monitoring and delivery of any care, treatment or therapeutic intervention.

(3)

It shall be the duty of the Secretary of State to provide the care or equipment or aid as described in this subsection whether directly or indirectly throughout England and Wales.

(4)

For the avoidance of doubt a local authority shall not be prohibited from providing or arranging services under subsection (1) above, provided they are delivered by the delegated authority of the NHS under the provisions within section 31 of the Health Act 1999 (delegated NHS functions).

(5)

In cases where services are provided under subsection (2) above, section 1(2) of the National Health Services Act 1997 (services free of charge) applies.

(6)

Nothing in this section affects the provisions of the National Health Services Act 1977.

Clause 56

THE LORD RIX

262

Page 58, line 20, leave out from "shall" to end of line 31 and insert "require a person to contribute towards the costs of any service which is available to other persons without charge under provisions relating to the National Health Service; and such service, where a person is assessed to need it under relevant enactments, shall be provided at the expense of the appropriate Health Authority or other National Health Service agency"

THE LORD ARCHER OF SANDWELL

263

Page 58, line 24, at beginning insert "care for a prescribed condition and"

THE EARL HOWE
THE BARONESS CUMBERLEGE
THE LORD CLEMENT-JONES
THE BARONESS MASHAM OF ILTON

264

Page 58, line 24, leave out "by a registered nurse"

THE LORD MORRIS OF MANCHESTER

265

Page 58, line 24, at end insert "or health care by a person who is registered by any board established under the Professions Supplementary to Medicine Act 1960"

THE LORD ARCHER OF SANDWELL

266

Page 58, line 24, at end insert

"(1A)

In this section, "care for a prescribed condition" means any services including

(a)

the provision of care, or

(b)

the planning, supervision or delegation of the provision of care,

required by a person suffering from a prescribed condition, whether the same involves nursing care by a registered nurse.

(1B)

In this section, "prescribed condition" means any condition which the Secretary of State may from time to time prescribe by regulation."

THE EARL HOWE
THE BARONESS CUMBERLEGE
THE LORD CLEMENT-JONES
THE BARONESS MASHAM OF ILTON

267

Page 58, line 25, leave out subsection (2) and insert

"(2)

In this section, "nursing care" means any care (including any planning, supervision, or delegation of such care) which

(a)

is planned for a person by a registered nurse after assessing that person's need; and

(b)

is provided, delegated or supervised by a registered nurse."

THE LORD MORRIS OF MANCHESTER

268

Page 58, line 26, after "nurse" insert "or health care by a person who is registered by any board established under the Professions Supplementary to Medicine Act 1960"

269

Page 58, line 31, at end insert "or health care by a person who is registered by any board established under the Professions Supplementary to Medicine Act 1960"

THE EARL HOWE
THE LORD ASTOR OF HEVER

270

Page 58, line 31, at end insert

"( )

Before bringing this section into force the Secretary of State shall consult such bodies and organisations as he shall consider appropriate with a view to determining the funding and other arrangements necessary to implement it."

THE EARL HOWE
THE LORD ASTOR OF HEVER
THE LORD CLEMENT-JONES
THE BARONESS BARKER

271

Page 58, line 31, at end insert

"( )

The relevant authority shall make regulations requiring that any persons receiving any services which are not considered nursing care, as determined by this section, shall receive detailed information on the costs of the provision of the personal care and accommodation prior to any agreement for the provision of community care services being made."

Clause 57

THE LORD CLEMENT-JONES
THE BARONESS BARKER
THE BARONESS GREENGROSS

272

Page 59, line 5, leave out "on the appointed day" and insert "from 1st October 2001"

THE EARL HOWE
THE LORD ASTOR OF HEVER

273

Page 60, line 9, at end insert

"( )

Before bringing this section into force the Secretary of State shall consult such bodies and organisations as he may consider to represent the relevant interests of local government as to

(a)

the methodology to be used for calculating the amounts required to fund the arrangements provided for in this section;

(b)

the methodology to be used for calculating a fair and equitable distribution of such funding amongst local authorities; and

(c)

the means whereby such funding is to be transferred."

THE LORD RIX

274

Page 60, line 25, at end insert

"(11)

Nothing in this section shall authorise any movement of a person other than in that person's interests and with that person's consent."

THE LORD CLEMENT-JONES
THE BARONESS BARKER

The above-named Lords have given notice of their intention to oppose the Question that Clause 57 stand part of the Bill.

Clause 58

THE LORD CLEMENT-JONES
THE BARONESS BARKER

The above-named Lords have given notice of their intention to oppose the Question that Clause 58 stand part of the Bill.

Clause 59

THE LORD CLEMENT-JONES
THE BARONESS BARKER

The above-named Lords have given notice of their intention to oppose the Question that Clause 59 stand part of the Bill.

After Clause 59

THE LORD RIX
THE BARONESS GREENGROSS

275

Insert the following new Clause

"Mandatory disregard of property in certain circumstances

(1)

The Secretary of State shall, by regulations subject to approval by both Houses of Parliament, make provision requiring local authorities to disregard the value of an individual's property when that property is occupied in whole or in part, as his home, by a person or persons as prescribed.

(2)

Regulations under this section may, in particular, make provision prescribing the categories of person, and the conditions to be satisfied by a prescribed person, in relation to a mandatory disregard."

THE LORD MORRIS OF MANCHESTER
THE BARONESS GREENGROSS

276

Insert the following new Clause

"Duty to disregard financial resources in making assessment decisions

(1)

The National Health Service and Community Care Act 1990 (c.
19) shall be amended as follows.

(2)

After section 47(1) (assessment of needs for community care services) there shall be inserted

"(1A)

In deciding whether or not to carry out an assessment under subsection (1) above a local authority shall disregard any financial resources available to the person."

(3)

After section 47(3) there shall be inserted

"(3A)

Where a local authority has decided to carry out an assessment the authority shall give reasonable notice in writing that an assessment is to be carried out.

(3B)

Within 14 days of completing their assessment the authority shall notify the person in writing of the outcome, including details of

(a)

any needs that have been identified as a result of the assessment that require the provision of any community care services;

(b)

any community care services that the person will receive;

(c)

the statutory agency which is responsible for ensuring that such services are provided;

(d)

a summary of the charging structure that will apply for provision of such services by the authority;

(e)

the date on which services will commence;

(f)

in so far as the authority does not accept that needs identified by the person and the authority (or both) as requiring the provision of community care services call for the provision of such services, the authority shall inform the person of the reasons for this decision;

(g)

the right to request a review of the decision and of the time within which such a request must be made."

The Secretary of State may issue directions requiring that assessments shall commence and be completed within prescribed periods.".""

THE BARONESS GREENGROSS
THE LORD RIX

277

Insert the following new Clause

"Liability of relatives

(1)

The National Assistance Act 1948 shall be amended as follows.

(2)

Sections 42 (liability to maintain wife, husband or children) and 43 (recovery of cost of assistance from persons liable for maintenance) shall cease to have effect.

(3)

In section 48(3) (duty of councils to provide temporary protection for property of persons admitted to hospital etc) omit the words "or from any person who for the purposes of this Act is liable to maintain him".

(4)

In section 51(1) (failure to maintain) omit the words "or any person whom he is liable to maintain for the purposes of this Act".

(5)

In section 56(1) (legal proceedings) omit the words "other than a sum due under an order made under section 43 of this Act".

(6)

In Schedule 6 (transitional provisions) omit paragraph 19.

(7)

The Public Health (Control of Diseases) Act 1984 shall be amended as follows.

(8)

In section 46(5) (burial and cremation) omit the words "or from any person who for the purposes of the National Assistance Act 1948 was liable to maintain the deceased person immediately before his death".

(9)

The Local Authority Social Services Act 1970 shall be amended as follows.